11 comments:

Interesting that these guys had to be relatively smart in med school because (at least when I went) ortho residencies were competitive to get into. What dumbs them down? Too much bone dust to the brain? Maybe inhaling fiberglass fibers from cutting off casts?

In all seriousness, does that pass as valid documentation for Joint Commission and State Department of Health requirements? Or is this from a private practice that is not under such scrutiny? Just curious, is all. Thanks.

Given the number of tests/findings documented - it probably still qualifies, with the interpretation and history, as a "expanded problem-focused evaluation" as part of a established follow-up code, i.e., at least a level 2 visit (E&M code 99212).

I don't really know which is better; the overwhelming amount of cr*p that I find populating notes and that require a search party to find the impression and plan of the doc, or this brief, cryptic, and to the point note. Actuallly, I find this ortho note the more honest of the two!

Maybe if we were somehow paid on some incident of care basis, instead of this widget type basis that requires creating elaborate notes to justify a higher level of payment, we could all be more to the point and save ourselves all a heck of a lot of time. This ortho note is exactly that since surgical procedures tend to be paid by incident of care with a global payment for the surgery and the post op care out to 30 or 60 days. Thats also why you see ortho docs rarely see there patients post op because they have the residents or their nurse practitionrs handle all the post op care. One of the most common complaints of patients after surgery these days is "what happened to my surgeon? I have'nt seen them since I went under anesthesia!

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.